nails

Trauma Columnist · Jul 14, 2007

Usually fake nails are forbidden due to infection control issues. Nail polish is usually okay provided you follow the dress code of whatever institution you work at. Good luck.

Christie RN2006 · Jul 14, 2007

Depends on your hospitals policy. You should never wear fake nails, or long nails when working with patients. Nail polish is okay as long as it is fresh and not chipped. Fake nails, chipping nail polish and long nails harbor bacteria and increase both your risk and your patients risk of exposure.

Here is what the CDC says about nails... "Although the relationship between fingernail length and wound infection is unknown, keeping nails short is considered key because the majority of flora on the hands are found under and around the fingernails (156). Fingernails should be short enough to allow DHCP to thoroughly clean underneath them and prevent glove tears (122). Sharp nail edges or broken nails are also likely to increase glove failure. Long artificial or natural nails can make donning gloves more difficult and can cause gloves to tear more readily. Hand carriage of gram-negative organisms has been determined to be greater among wearers of artificial nails than among nonwearers, both before and after handwashing (157--160). In addition, artificial fingernails or extenders have been epidemiologically implicated in multiple outbreaks involving fungal and bacterial infections in hospital intensive-care units and operating rooms (161--164). Freshly applied nail polish on natural nails does not increase the microbial load from periungual skin if fingernails are short; however, chipped nail polish can harbor added bacteria (165,166)."

nightmare, RN · Jul 14, 2007

We were always told not to wear nail polish as it can flake off and contaminate a wound for instance. I still never wear nail polish but I do buff my nails to a nice shine. False nails could be a definite skin hazard especially amongst those with compromised skin integrity and again there is the risk of them falling off and contaminating wounds etc.

justme1972 · Jul 14, 2007

I would give anything if I had nails that were hard enough to allow to grow and nail beds that were longer than 1/4 " deep...yup, you read that right.

My nails, rip off...down past the quick without, at minimum an acrylic overlay...that is several days of nothing that can burn them near, and to me...increases my risk for infection to MYSELF.

My nails are like paper...it's an hereditary condition that all the polishes, vitamins, and polish doesn't fix. When I discovered overlay, I thanked God every day for it. For the first time in my life I didn't have to worry about going through tons of band-aids to patch over torn nails. It was a way to make my own nails, thicker. I never wear colored polish, only French, and I keep clear sealant at home so it never chips and my happy butt is in my manicurist's chair every Friday.

I am very curious to see what the infection risk to nurses are that have these open wounds on their nail beds working in a hospital.

Not everyone wears them for vanity reasons...

Katnip, RN · Jul 14, 2007

I'm just wondering if you've seen a dermatologist about your nail condition. There may be something that's not over the counter that could help.

justme1972 · Jul 14, 2007

I'm just wondering if you've seen a dermatologist about your nail condition. There may be something that's not over the counter that could help.

Oh yeah...you name it, I've taken it. Geletin tablets, every conceivable vitamen, even the prenatals didn't work. I even used to only wash my hands with water when dirty, but when I took baths and showers, I would put on rubber gloves, tape the ends, so the water wouldn't soak into my nails. I once even spent $104 on a single bottle of a product that supposedly had enzymes in it that would harden nails over time...didn't work...it was something I found over in Europe.

My nails are so thin, I even have to pay extra before they put on artificial nails...to not use the electric filing bits, but to prep them by hand b/c it would make them so thin, I couldn't finish the process.

I will probably have to address this with my nursing school. I may have to carry a nail brush in my pocket or have the clinical instructor to check my nails for uplifting, etc. I don't have any issues with them lifting when I went to having them done every 7 days instead of every 14. I keep them manicured so well and have them buffed thin to wear most people can't tell the difference without extremely close scrutiny.

I just can't imagine spending a career in nursing with what I consider to be, a handicap that is easily corrected. With the frequent handwashing, there is no way, that once my nails grew out a little, I would survive a day before they ripped on something, and that can't be good either with all of the bacteria around.

I am obviously not trained in infection control...but still don't see how this is a risk to the patients. Gloves are worn for virtually all patient contact that involves your hands except for taking vitals. I would think the door knobs to the rooms would be more of an issue than artificial nails.

PS: I'm wondering if the issue is the acrylic rather than the artificial part. Does anyone have information on other types of nails such as silk, porcelin, fiberglass, etc.

RNsRWe, ASN, RN · Jul 15, 2007

We were always told not to wear nail polish as it can flake off and contaminate a wound for instance. I still never wear nail polish but I do buff my nails to a nice shine. False nails could be a definite skin hazard especially amongst those with compromised skin integrity and again there is the risk of them falling off and contaminating wounds etc.

While I agree that well-kept polish is fine and chipping is not, this particular reason doesn't make much sense to me. In ANY instance where "flaking polish" could contaminate a wound, why would you not be wearing gloves (sterile gloves, even)? If the wound could be contaminated in such a manner, it would not be open to air to rub on sheets, etc...it would be under wraps, in a dressing. Polish would never be an issue here. And I do have to say that the idea of doing a sterile dressing change barehanded (such that a fake nail could "fall off" and contaminate it) seems silly :)

ICRN2008, BSN, RN · Jul 15, 2007

Acrylic nails can harbor fungus, which is particularly dangerous to patients with compromised immune systems. I would try to find another solution with the help of a dermatologist if at all possible.

Christie RN2006 · Jul 15, 2007

Just look up "artificial nails" on the CDC website and you will find tons of information! I did a research study on hand hygiene in the hospital setting and used http://www.cdc.gov for quite a bit of my research.

"Studies have shown that hospital personnel with artificial

nails harbor more potential pathogens both before and after

handwashing than personnel with natural nails."

"Artificial nails contribute to nail changes that can increase the

risk of colonization and transmission of organisms from

HCWs to patients."

shellsincanada · Jul 15, 2007

I remember hearing about a case where they linked the deaths of several newborns in the nicu to one nurse with artifical/acrylic nails and bacteria under them. I will see what I can find?

JaneyW · Jul 15, 2007

Hopeful-

I really hate to rain on your parade, but you need to do your homework before spending all the time, money and effort on nursing school if you can't give up your fake nails. I have yet to work anyplace that allows them. There have been numerous studies about them being an infection risk no matter how careful you are. I feel for you, because I believe what you are saying, but that isn't going to change the fact that they simply aren't allowed in patient care areas. Period.

You posted that you have tried many things--have you seen a dermatologist or doctor? They may have some solution that will improve your condition to the point of being able to go natural. You need to look into it now. Trust me, it is a real, evidence-based policy in all hospitals. As with everything, there are those who break the rules, but do you want to be that person? Good luck with finding a good solution.